• Introduction

    Dermal Fillers (Hyaluronic Acid gel fillers)

This is a very popular cosmetic treatment and over the past two decades it has revolutionised the treatment of wrinkles and volume loss.

Dermal fillers can be injected in a deeper fashion to restore volume in areas that have begun to droop and hollow. Typical areas where this is the case are:

  • Cheeks
  • Nose to mouth lines (nasolabial)
  • Marionette lines
  • Chin
  • Temple hollowing

Lips and around the mouth (perioral)

Dermal fillers are also used to volumise the lips. This is one of the most popular uses of dermal fillers. It is also important to understand that fillers aren’t just used to give young women full lips. They can also be used to restore the anatomical changes seen in older lips and as a result provide excellent rejuvenation of lips that have lost volume, definition and structure through the ageing process.

Hyaluronic acid is a safe and versatile tool in the treatment of facial ageing when used by an experienced and knowledgeable medical professional. Misconceptions about filler are unfortunately common due to the way that they are often portrayed in the media.

Fine lines

Lower density (softer) HA fillers are used sometimes within the skin to help with the treatment of fine lines and wrinkles. Major creases are best treated through appropriate deeper volume restoration with higher density fillers. Although fine lines can be visibly improved with low density HA fillers, treatments such as fully ablative CO2 laser resurfacing provide a more powerful and permanent way of dealing with fine wrinkles around the mouth and the eyes. The advantage of treatment with Dr Hussein is that he is an expert in all aspects of cosmetic dermatology and as a result will be able to provide the most appropriate treatment whether it be filler, laser resurfacing or something else.

Tear trough Correction

This is a technically complex area of the face that must be treated by someone who has significant expertise in assessing and treating the area. Multiple problems can lead to ageing around the eye. Hereditary factors, dermatochalasis (skin laxity), fat pad prolapse, muscle weakening, hypermelanosis, age related bone remodelling and vascular changes can all combine in varying quantities to age the area around the eye.

If treatment of the tear trough is appropriate (it may be that fully ablative CO2 laser tightening or surgical blepharoplasty with fat reduction may be more appropriate) then it should be performed by someone with comprehensive anatomical knowledge of the area and a significant amount of case experience. Please refer to Dr Hussein’s video lecture below for a better understanding of this complex area.

Nasal correction with filler (Non-surgical rhinoplasty)

Nasal and peri-nasal injection with filler has become a very popular in the last decade. The nose is an anatomically complex region and unfortunately the incidence of potentially dangerous complications is highest here compared to any other region on the face. Blockage of blood vessels causing skin necrosis and blindness are two of the most severe complications of filler injection that can arise in injections of the nose.

Due to the lower two thirds of the nose being soft and cartilaginous in structure HA fillers have significantly low success in changing structural nasal anatomy.

Nasal corrections that CAN be achieved to a reasonable degree with HA filler are as follows:

  • Dorsal hump softening/saddle shape deformity (but at the cost of flattening of the nasal-frontal angle which can then look odd).
  • Dorsal columns can be adjusted giving the illusion of a straighter nose.
  • Softening of a bulbous nose tip through widening and increasing the height of the nasal dorsum.

Nasal corrections that CANNOT be achieved effectively or to any significant degree with filler are as follows:

  • Correction of lateral (sideways) deviation of the nose or septal deviation
  • Lifting of the nasal tip or upward rotation of the tip
  • Increasing the height of a flat radix (sharpening and height increase for those with a flatter nose)

Any changes are relatively short lived and each time this process is repeated (which by nature has to be every 6 months) the cumulative risk of severe complications arises. The best advice when it comes to nasal correction is to seek a safer and more long-term surgical solution in the hands of an experienced plastic surgeon.

A high risk of complications will be encountered if fillers are used in the treatment of patients who have undergone previous nasal surgery (rhinoplasty) and should only be performed by plastic or ENT surgeons with significant rhinoplasty experience.